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[Social psychological and sociocultural aspects of alcohol drinking and alcoholic intoxication behind the wheel].

The paper deals with socio-psychological and socio-cultural problems of drunken driving and of alcohol-consumption in general. It is the intention to make evident how the way to show a certain behavior is imbedded in more comprehensive conditions. The contradictory relations between the role of individual traffic and of alcohol consumption in a society on the one hand and the phenomenon of drunken driving on the other hand are pointed out, as well as the different valuation of social drinking and alcohol dependence. The way of profanation of the drug "alcohol" and the importance of social influence on consumption and effect of the drug are shown, taking into consideration the subjective position of the individual in the society. Finally the role of the state and possibilities of a systemic approach against drunken driving are dealt with.

Accidents, Traffic

Selected medical and social factors and alcohol drinking in Polish seafarers.

Seamen belong to these occupational groups which more than others are exposed to the alcohol dependence. Numerous stressing factors often make them "escape in alcohol drinking". Drinking alcohol at sea is particularly dangerous. Alcohol is the contributing factor in many catastrophes, in "unexplained" disappearance of people from ships, and accidents at work. Due to the peculiar character of the relations among crew members during the voyage, information about alcohol drinking by seamen is fragmentary, little precise, and seldom reported. A group of 450 seafarers directed by the shipowner were examined by the author, to assess whether they were alcohol addicts. Then the groups of the dependent and non-dependent were compared according to the selected medical-social parameters. No distinct connections between alcohol drinking and these factors were revealed, what seem to speak for the thesis that alcohol drinking in seamen is brought about by the specificity of the work at sea alone and with the personality traits.

Adult

[Alcohol drinking behaviors--physiological and sociomedical factors].

Alcohol drinking behavior is usually studied from two perspectives, factors leading to drinking behavior and the behavioral effects of alcohol drinking. Many detailed medicolegal, pharmacological and psychiatric studies have been conducted on the behavioral effects of alcohol drinking. Few studies have considered the biological aspects of a desire for alcohol. However, these issues can not be ignored. The role of genetic, environmental and nutritional factors in alcohol preference has extensively debated. Recently, biochemical, physiological and pharmacological studies have also been performed to elucidate the mechanism of the desire for alcohol. In this study, the biological aspects of drinking behavior and alcohol preference have been studied using inbred strains of mice as an animal model on alcoholism. In addition, factors affecting drinking behavior of human beings are discussed based on the results obtained from a medico-legal study of alcohol-related cases. 1. Alcohol preference in several animal species The alcohol preference expressed as a ratio (%) of the volume taken (water and 10% (v/v) alcohol solution), was not constant in several animal species. The preference ratio was observed to be 2.7 +/- 0.7, 3.7 +/- 0.8, 22.0 +/- 19.8 and 39.6 +/- 5.4 in male inbred strains of SAMP2, DBA/2cr, B10.Br/Sg and C57BL/6J mice respectively, and 10.7 +/- 7.6, 15.9 +/- 13.6, 31.3 +/- 22.6 and 32.4 +/- 16.7 in male Donryu, DA, Wistar and Buffalo rats respectively, and 91.3 +/- 9.1 in male Golden hamster, and 2.1 +/- 0.3 in Hartley guinea pigs. Rabbits and Japanese monkeys do not demonstrate high alcohol preference. By comparison, the alcohol preference of a Japanese people was estimated to be approximately 11-35% on the basis of data obtained by questionnaire. 2. Development of alcohol dependence and withdrawal by voluntary alcohol intake in mice Eight strains of male mice, C57BL, C3H, SWM, SW, KK, KSB, KR and DBA, were offered a choice of water or 10% sake solution (sake containing 10% alcohol). Both young (3 months of age) and old (8 months of age) groups were studied simultaneously. The degree of intoxication was measured by recording the drinking behavior on a pulse recorder, by measuring gas-chromatographically the blood alcohol concentration, by taking depth electroencephalogram readings and so on. Intoxication, shown by lack of coordination such as grossly impaired gait, was observed only in the older mice of a strain with a moderate natural alcohol preference such as C3H, SWM, SW, KK and KSB.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking

Increased alcohol selection in rats after alcohol drinking paired with recovery from thiamine deficiency.

Repeated pairings of novel alcohol solutions (5% or 7.5% w/v) with IP injections of 267 microgram/kg thiamine in thiamine-deficient male Sprague-Dawley rats resulted in the ingestion of pharmacologically active doses of alcohol in association with recovery. Mean alcohol intake in a postrecovery fluid choice situation exceeded metabolic capacity for 7--10 days; such intake was not observed in nondeficient pair-fed rats or in formely deficient rats whose recovery was not paired with alcohol drinking. Alcohol was self-selected in the presence of water under conditions where the rats had no experience with water while deficient, but the presence of 0.1% saccharin as a postrecovery alternative to alcohol was sufficient to abolish the elevated intake. Absolute alcohol intake and blood alcohol levels on recovery days and during self-selection were comparable with 5% and 7.5% alcohol solutions.

Alcohol Drinking

Effect of naltrexone on alcohol consumption during chronic alcohol drinking and after a period of imposed abstinence in free-choice drinking rhesus monkeys.

Relapse into problematic alcohol drinking is a serious problem in the treatment of alcoholism. Free-choice drinking rhesus monkeys show relapse-like behaviour after imposed abstinence of alcohol, by immediately reinitiating ethanol intake at an increased level. The relapse-like behaviour of the monkeys seems not induced by physical withdrawal, but rather argues for a resistance to extinction of ethanol-reinforced behaviour. It has been suggested that endogenous opioids play a role in the positive reinforcing effect of ethanol. In this study, the effect of the opiate antagonist naltrexone was investigated in eight adult male rhesus monkeys (Macaca mulatta) who had about 1 year experience with alcohol drinking, under two conditions: 1) (expt 1) during continuous and concurrent supply of drinking water and two ethanol/water solutions (16% and 32% (v/v], and 2) (expt 2) after 2 days of alcohol abstinence. In both experiments, each monkey received six doses of naltrexone (0.02, 0.06, 0.17, 0.5, 1.0, 1.5 mg.kg-1); each dose was paired with a placebo injection (im) in a cross-over design. Consumption was measured from 16.00 hours in the afternoon (30 min after injection) to 9.00 hours the next morning. In experiment 1 naltrexone reduced total net ethanol intake in a graded dose-dependent manner. The effect of naltrexone was apparent shortly after injection, and lasted until the following day. Consumption of drinking water was reduced only shortly after injection. In expt 2, reduction of net ethanol intake was largely restricted to the first few hours of reinitiation of alcohol drinking, i.e. the period in which the abstinence-induced increase was manifest. Consumption of drinking water was not affected by naltrexone. Naltrexone hardly influenced consumption of the non-preferred ethanol solution of 32%. It is postulated that the opioid modulation specifically interacted with positively reinforced behaviour. In expt 2 naltrexone reduced ethanol intake at a lower dose (0.17 mg.kg-1) compared to expt 1 (0.50 mg.kg-1), but net ethanol intakes however remained higher. It might be that alcohol abstinence resulted in altered opioid activity, leading to increased ethanol-seeking behaviour. The renewed presentation of ethanol solutions (also) might have stimulated reinitiation of alcohol drinking, representing conditioned incentive stimuli. The reported monkey model of relapse in alcohol drinking could be a useful tool to evaluate new hypotheses and experimental treatments with respect to human alcoholism.

Alcohol Drinking

Analysis of spontaneous alcohol drinking in rhesus monkeys.

This analysis aims at determining to what extent spontaneous alcohol drinking in adult male rhesus monkeys (Macaca mulatta) represents ethanol-directed behaviour. It is shown that in a condition of free access to an ethanol/water solution (2 percent v/v) and drinking water, alcohol drinking was initiated in all subjects (n = 4) within a few days, without any specific induction procedure. Relationship between drinking behaviour and ethanol concentrations was studied in 8 subjects by use of a concurrent 3-bottle-design. 2 bottles containing ethanol solution (concentrations 2.4; 4.8; 8.16; 16.32 percent v/v), 1 bottle contained drinking water. When ethanol concentrations in the solutions increased, consumption of ethanol solutions decreased, of drinking water increased, and of total water decreased. Net ethanol intake from a certain solution was influenced by its concentration and the concentration of the concurrently available solution. After an initial increase, total net ethanol intake remained relatively constant. Consumed amounts of ethanol (on the average 2-6 ml.kg-1 per day) could lead to notable blood ethanol levels. Drinking from ethanol solution was not just an alternative for ingesting water. The observed alcohol drinking is interpreted as resulting from a central reinforcement of ethanol intake and avoidance of negative, potentially harmful effects of ethanol.

Alcohol Drinking

Drugs to decrease alcohol drinking.

A wide variety of drugs have been tested in experimental animals and several have been found that reduce voluntary alcohol drinking. The available evidence suggested that the same drugs also reduce alcohol drinking in alcoholics. Various factors limited or prevented the clinical use of the these drugs. Our working hypothesis has been that alcohol drinking is a learned response, reinforced primarily from alcohol in the brain, and that an alcoholic is a person in which this response and the related craving have become so strong that they dominate the behaviour and interfere with normal functioning. Learned responses are extinguished if they are made repeatedly while the reinforcement is blocked, and opiate antagonists appear to block the reinforcement from alcohol. A series of experiments support the hypothesis that drinking alcohol while an antagonist is present extinguishes the alcohol-drinking response in rats. The antagonists are non-addictive and at least naloxone appears to be safe. Clinical trials are now needed, but the present results suggest that this extinction procedure might be a useful adjunct to the treatment of alcoholism.

Alcohol Drinking

[The correlation of social support with stress and alcohol drinking in adolescents].

The present review is concerning with the influence of social support on stress (14-20 years old students). The analysis of the data supports the hypothesis that social support is important for human wellbeing: Boys and girls with high social support from parents and teachers drink less alcohol than those with low social support. They also have less difficulties to identify with the values of the adults, concerning life style. Besides the main effect social support also has a buffer function: students with high social support describe less problems and attribute them more external. Social support can therefore be interpreted as a kind of reducing stress.

Adolescent

A statistical approach to an alcoholic drinking history.

The drinking history of a middle-aged male was analyzed statistically on the basis of eight and a half years of notes on the number of drinks consumed per day. During the period his average number of drinks per drinking day increased from about 7 in 1974 to a peak of about 16 in 1980 while the number of abstinent days varied between 23% and 54% with no clear trend. These figures are of the same magnitude as published reports on drinking among alcoholics. Time-series models of intake or drinking frequency could not describe adequately the time-structure of annual or monthly consumption. Occurrence of drinking was analyzed as a random series of events. The time-structure of the series was highly irregular and deviated greatly from the Poisson hypothesis which assumes that each day has an equal probability of becoming a drinking day independently of previous days. Instead, drinking days were clustered into sprees with an average length of 7 days, high variance and a very skew distribution, separated by abstinence periods with an average length of 4 days and a similarly shaped distribution. The entire history could be partitioned into 286 alternating drinking and abstinence intervals, one day intervals included. The drinking rhythm was very stable: no significant trends in the lengths of either type of interval could be found. The main findings are the surprising stability of the drinking rhythm, its independence of the growing amounts consumed, and the independently varying abstinence interval lengths. Even in the absence of reporting and memory bias, such a pattern of drinking may produce very inaccurate recall of the actual long-term alcohol intake, if the recall period is short. The results suggest that periods shorter than one month should be avoided when asking questions about alcohol intake, for example, in research on the effects of treatment on alcoholism or alcohol intake on health.

Adaptation, Psychological

A twin study of the effects of the Vietnam conflict on alcohol drinking patterns.

This study examines the association between military service in Southeast Asia and alcohol drinking patterns in 2,169 male-male monozygotic twin pairs who both served on active military duty during the Vietnam era (1965-75). Data on alcohol drinking were collected in 1987 by mail and telephone interview. The alcohol drinking measures include three indicators of abstention (lifetime abstainer, lifetime non-regular drinker, and current abstainer) and two indicators of consumption (average daily ethanol consumption and high consumption). In unadjusted and co-twin adjusted analyses, neither service in Southeast Asia nor combat exposure was significantly associated with any measure of abstention. In the co-twin adjusted analysis, there was no association of Southeast Asia service and combat exposure with average daily ethanol consumption. After adjustment for co-twin effects, 4.0 percent of non-Southeast Asia veterans were high consumers compared to 6.7 percent of Southeast Asia veterans who served in high combat. We conclude that prior military service in a war zone has a relatively modest long-term effect on the alcohol drinking patterns of male veterans.

Adult

Endocrine profile during acquisition of free-choice alcohol drinking in rhesus monkeys; treatment with desglycinamide-(Arg8)-vasopressin.

This study concerns the effect of spontaneous acquisition of alcohol drinking in rhesus monkeys on plasma levels of beta-endorphin, ACTH, prolactin, cortisol and testosterone. Twelve monkeys had free-choice access to water and two ethanol/water solutions (1%, 2%, v/v) for 4 weeks. During the first 2 weeks, six monkeys were injected (i.m.) twice daily with 0.50 microgram/kg desglycinamide-(Arg8)-vasopressin (DGAVP), a neuropeptide, that has been postulated to interfere with central positive reinforcement processes. The other six were treated with a placebo. Hormonal plasma levels after the first 2 weeks and after another 2 weeks of alcohol drinking were compared to pre-alcohol hormonal levels (baseline). The placebo-treated subjects significantly increased, but the DGAVP-treated subjects significantly decreased ethanol intake over time. After 2 weeks of alcohol, significant increases were found in beta-endorphin and ACTH levels. After 4 weeks, prolactin was increased, cortisol decreased and particularly beta-endorphin remained significantly increased. No relationship was found between baseline hormonal levels and subsequent ethanol intake. No significant differences in plasma hormonal changes were observed between DGAVP- and placebo-treated subjects. Two placebo-treated subjects that showed the highest increase in ethanol intake over time, reacted differently, by reducing beta-endorphin and ACTH levels over time, showing the largest decreases in cortisol and hardly any prolactin reaction. It is concluded that spontaneous alcohol drinking by naïve subjects disturbs hormonal processes and that two animals deviated with respect to the acquisition in alcohol drinking and endocrine functioning.

Adrenocorticotropic Hormone

Importance of delta opioid receptors in maintaining high alcohol drinking.

We have previously reported that naloxone, a nonspecific opioid receptor antagonist, suppresses alcohol but not water consumption by male rats that have been genetically selected for high voluntary alcohol drinking. However, the identity of the specific opioid receptor subtype that may mediate alcohol drinking is not known. This paper reports that a selective delta opioid receptor antagonist is as effective as naloxone in suppressing alcohol consumption and that an enkephalinase inhibitor, which potentiates the action of endogenous enkephalins, increases alcohol intake. These results suggest that alcohol-induced activation of the endogenous enkephalinergic system, and occupation of delta opioid receptors, are involved in the maintenance of continued alcohol drinking.

Alcohol Drinking

Alcohol drinking and high blood pressure: data from a 1980 national cardiovascular survey of Japan.

Many epidemiological cross-sectional studies have confirmed that alcohol drinking is related to high blood pressure. However, the impact of alcohol drinking on high blood pressure in the general population including older people has only been reported on in a few studies. The association between alcohol drinking and blood pressure or the prevalence of hypertension was examined using cross-sectional data of 4795 men and 6102 women aged 30-94, randomly selected from the Japanese population in 1980. The response rates were 74 and 84% for men and women, respectively. The prevalence of hypertension adjusted for body mass index (BMI, kg/m2) was significantly higher in everyday male drinkers than in male non-drinkers from the youngest age group (30-39 years) to oldest age group (70 years and over). A relationship between alcohol and blood pressure was found only in the youngest age group (30-39 years) of female drinkers. In each 10-year age-group of men, the BMI-adjusted systolic and diastolic blood pressures in everyday drinkers were 7-10 and 4-6 mmHg higher than those in non-drinkers. The relationship between alcohol and blood pressure in men was confirmed by multiple regression analysis adjusting for age and BMI in both younger (30-59 years) and older (60-94 years) people. The impact of alcohol drinking on blood pressure in men should be taken into account in the primary prevention of blood pressure related diseases and in the treatment of hypertension in both younger and older people.

Adult

[Alcohol drinking behavior based on the neurochemical background. II. Alcohol preference and aging].

The present studies have investigated the relationship between alcohol behavior and aging in several strains of mice. First experiments have carried out whether a free choice of 10% (v/v) ethanol and tap water for 4 weeks changes the alcohol preference and the brain neurotransmitters in three inbred strains of mice, C57BL/6J, C3H/He and DBA/2Cr. Mice of these strains showed mean ethanol intakes of 4.41, 1.76 and 0.77 g/kg/day, respectively. Levels of the brain monoamines did not change in the alcohol preferring C57BL/6J mice, but in those with less preference of alcohol, C3H/He and DBA/2Cr, there were significant increases in dopamine and 5HT levels during the four weeks experiment. Second studies have reexamined if the factor of aging affects on the alcohol preference or drinking behavior in mice. Intake of 10% ethanol (ml/day) and alcohol preference (%) increased significantly with age. A further study was conducted in which groups of 16 week old mice were checked for alcohol preference along with a completely naive control group. The alcohol preference and alcohol intake were maximum in mice given free access to ethanol at 4 weeks of age. These results suggest that a) the mouse strain with a low preference of alcohol undergo neurochemical changes after exposure to 10% ethanol and water even be free choice, and b) alcohol drinking behaviors are not only affected on the general aspects but also the factor of aging and the conditions in which mice have expressed the accesses to alcohol.

Aging

[The main cause of diabetes (type II): "normal" alcohol drinking].

In 1214 adult persons, the relationship between alcohol consumption, the "liver enzymes" and other metabolic parameters, including the serum lipids, were investigated. In 798 of the persons, glucose tolerance tests with measurement of plasma insulin were performed (young and old male and female adults, either volunteers or patients without liver-related diseases). There was a high correlation of the three transferases GOT, GPT and GGT not only with the reported alcohol consumption but also with the plasma insulin. Most of the insulin increase, however, occurred in that range of the three transferases which, so far, has erroneously been considered to be the normal one. The C-peptide showed the same behaviour. Plasma insulin was also raised in relation to overweight, but only in persons with the sum of the three transferases over 30 U/l, not in persons who did not drink alcohol and who had really normal transferases (sum of the three transferases below 30 U/l measured at 25 degrees C). The quotient of plasma insulin divided by the relative body weight (Broca Index) was constantly low in the range of really normal transferases (up to 30 U/l), thereafter rising significantly, but only in the range of the transferases so far erroneously considered to be the normal one (GOT to 17, GPT to 22, GGT to 28 U/l, thus sum up to 67). Serum glucose in the tolerance test also rose with the transferases but much less than the plasma insulin. The correlation between both GGT and the sum of the three transferases with the plasma insulin was significantly positive and independent of the relative body weight. It is concluded that overweight (which is generally believed to be the main risk factor for non-insulin-dependent diabetes), and insulin resistance (which leads to hyperinsulinaemia), are largely caused by the toxic effects of "normal" daily alcohol, more in the human male than in the female. Hyperinsulinaemia (which blocks lipolysis) is caused by a toxic effect of ethanol and its metabolites, independent of caloric input and overweight. Hyperinsulinaemia is at least in the human male at present, probably the most important cause of obesity. In obesity, caused by "normal" alcohol consumption, a vicious circle occurs: the enhancement of the triglycerides and, consequently, the free fatty acids leads to a further decrease of glucose utilization by the muscle. A continuously high glucose level has toxic effects: eventually the beta cells of the pancreas are exhausted.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult